Hesperian Health Guides

How to know if your child needs help

In this chapter:

Babies develop at their own pace. Some develop more quickly than others. But most children grow and develop new skills at about the same age. By age 2, most children can speak or sign about 50 to 200 words. A child usually knows about 900 words at age 3, and 1500 words by age 4.

The important thing is that a child continue to learn new skills. But when a child is not learning a skill even long after other children
A woman helps her daughter write in her notebook.
her age have learned it, this is usually a sign that she may have a problem or need extra help.


This chart describes some of the communication skills children learn and when most children learn them. Parents can use the chart to decide which skills their children already know, and which skills they need to learn. To decide what activities to do first, start by asking yourself, "Is my child doing everything that other children his age are doing?" See Child Development Charts for more information on the ages and order in which children usually learn new skills.

3 months 6 months
  • responds to familiar voices or faces
  • reacts to sudden sounds or movements
A man holding his small baby.
  • makes simple sounds or gestures
  • turns head toward movements or sounds
A baby lies on his mother's chest, reaching for her face.


1 year
2 years
  • joins sounds together or repeats hand shapes
  • begins to name things
  • understands and responds to simple words or signs
  • imitates single signs
A baby making sounds as she shakes a rattle.
ba-ba ga-ga
  • uses simple words or signs
  • uses sentences with 2 and 3 words or signs
  • knows 50 to 200 words or signs
A small child uses sign language.
My cup.


3 years 5 years
  • understands most simple language
  • knows and uses 500 to 1000 words or signs
A small boy and his mother make signs to one another.
Where is the biscuit?
I ate it.
  • talks or signs about what he has done
  • asks many questions
A young boy speaks to his father as they walk with hands held.
What are those people doing?


NOTE: Some children who cannot hear well may have other problems. Their minds and bodies could be slow to develop for other reasons. See the book Disabled Village Children for more information on how to help a child whose mind and/or body are slow to develop.

You can help your child learn

If you think your child's communication is not developing as it should, you can help him learn. Parents often think that only someone with professional training can help their child. But as a parent, you know your child better than anyone else, so you can make a big difference in his development.


A woman thinking as she sits beside her son, touching his shoulder.
Other children Ali's age know how to behave with each other. I think it's important for him to learn how to get along with other children.



This page was updated:09 Aug 2022